Debranching Thoracic Endovascular Aortic Repair for Kommerell's Diverticulum with Right-Sided Aortic Arch / 日本心臓血管外科学会雑誌

We report a case of debranching thoracic endovascular aortic repair for Kommerell's diverticulum with right-sided aortic arch in 78-year-old women. The computed tomography (CT) demonstrated Kommerell's diverticulum with a right-sided aortic arch and the trachea and esophagus were compressed by the diverticulum. The diverticulum had a maximum diameter of 32 mm, and surgical intervention was chosen because of the aneurysmal change and the possibility of rupture. We performed endovascular aortic repair for Kommerell's diverticulum with a right-sided aortic arch because of low lung function and low frailty. The patient was discharged on the 21st postoperative day. There was no evidence of aortic event during 2 years follow up.

Constrictive Pericarditis due to Thymic Cancer Developed 17 Years after Resection of Thymoma with Myasthenia Gravis / 日本心臓血管外科学会雑誌

<p>It is reported that myasthenia gravis (MG) with thymoma occupy 20% of all MG and extended thymectomy is recommended. After having operation, it is rare, but cases of recurrence of thymoma and, what is worse, thymic cancer from residual thymus tissue are reported. A 69-year-old man came to our hospital to have his dyspnea level examined. He had a past history of MG with thymoma and he had undergone extended thymectomy 17 years previously. Enhanced CT showed pericardial thickening and many tumors in the epicardium. Catheterization study showed dip and plateau pattern of left ventricular pressure. We therefore diagnosed constrictive pericarditis (CP). We performed pericardiectomy under cardiopulmonary bypass. He was discharged ambulatorily on postoperative day 24. Histological findings of the tumor and the pericardium showed that they were dissemination of thymic cancer. It was considered that thymic cancer caused CP and it was an extremely rare case. We think this is the first report to the best of our knowledge.</p>